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APCs Weekly Monitor

This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations. Topics include the outpatient code editor (OCE), complex coding issues, beneficiary co-payment discounting, and cross-department APCs tracking.

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APCs Weekly Monitor

Issue 4, January 27, 2012

• Tip: Set rates that reflect intent of new codes

  CMS expects hospital charges to reflect the relative resources that are required to provide a...

• Pay-per-view: Code and guideline changes spread throughout surgery subsections

  In total, the AMA added 60 new codes throughout the surgery section of the 2012 CPT® Manual, 18...

Issue 5, February 3, 2012

• Q/A: New device pass-through categories

  Q: Will CMS ever approve any new device pass-through categories?

• Tip: Note physician supervision changes

  CMS finalized two significant changes to the physician supervision requirements as part of the 2012...

• Pay-per-view: Note major updates to pathology and laboratory section

  Coders can find the largest number of new codes in the pathology and laboratory section of the 2012...

• Trivia

  In the 115 years for which records are available, how many times has Punxsutawney Phil predicted an...

Issue 4, January 27, 2012

• Q/A: Reporting negative pressure therapy

   Q: The new guidelines for the integumentary system section state that CPT® codes...

• Trivia

  The oldest known valentine still in existence today was sent in which year?

Issue 3, January 20, 2012

• Q/A: Reporting molecular pathology codes

  Q: Addendum B of the APC updates for 2012 lists the new molecular pathology codes as status...

• Tip: Corrrectly code image-guided lumbar decompression

  Percutaneous image-guided, minimally invasive lumbar decompression witha specially designed toolkit...

• CMS finalizes numerous provider-friendly OPPS changes for CY 2012

  Fortunately for providers, CMS decided not to cap outpatient payment rates for cardiac...

• Trivia

  Which U.S. state’s motto is Sic semper tyrannis (Thus always to tyrants)?

Issue 2, January 13, 2012

• Q/A: Correct use of modifier -FB and -FC

  Q: Our billing office is concerned about reports that the OIG is auditing for appropriate use of...

• Tip: Take note of inpatient-only list revisions

  CMS removed 10 codes from the inpatient-only list as part of the 2012 OPPS Final Rule. For CY 2012...

• Pay-per-view: Reevaluate charge setting in light of 2012 OPPS final rule

  Hospitals received a timely reminder about the importance of properly setting charges in CMS' 2012...

• Trivia

  What is fear of Friday the 13th called?

Issue 1, January 6, 2012

• Q/A: National Correct Coding Initiative edits

  Q: What advice can you offer providers with respect to 2012 OPPS and National Correct Coding...

• Tip: Understand the three-day rule

  The three-day rule bundles certain outpatient preadmission services into the inpatient MS-DRG...

• Pay-per-view: CMS finalizes numerous provider-friendly OPPS changes for CY 2012

  Fortunately for providers, CMS decided not to cap outpatient payment rates for cardiac...

• Trivia

  In Greek mythology, who is the god of fire?